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Tobramycin

Drug Information

Tobramycin is an "aminoglycoside" antibiotic used to treat infections caused by many different bacteria. Tobramycin is usually administered by intravenous (i.v.) infusion, intramuscular (i.m.) injection, or inhalation. Tobramycin is available in special preparations to treat eye infections, alone and in a combination product.

Common brand names:

TOBI

Summary of Interactions with Vitamins, Herbs, & Foods

Replenish Depleted Nutrients

Calcium, magnesium, and potassium depletion requiring prolonged replacement were reported in a child with tetany who had just completed a three-week course of i.v. tobramycin.1 The authors suggest this may have been due to kidney damage related to the drug. Seventeen patients with cancer developed calcium, magnesium, and potassium depletion after treatment with aminoglycoside antibiotics, including tobramycin.2 The authors suggested a possible potentiating action of tobramycin-induced mineral depletion by chemotherapy drugs, especially doxorubicin (Adriamycin®).

Until more is known, people receiving i.v. tobramycin should ask their doctor about monitoring calcium, magnesium, and potassium levels and the possibility of mineral replacement.

Calcium, magnesium, and potassium depletion requiring prolonged replacement were reported in a child with tetany who had just completed a three-week course of i.v. tobramycin.3 The authors suggest this may have been due to kidney damage related to the drug. Seventeen patients with cancer developed calcium, magnesium, and potassium depletion after treatment with aminoglycoside antibiotics, including tobramycin.4 The authors suggested a possible potentiating action of tobramycin-induced mineral depletion by chemotherapy drugs, especially doxorubicin (Adriamycin®).

Until more is known, people receiving i.v. tobramycin should ask their doctor about monitoring calcium, magnesium, and potassium levels and the possibility of mineral replacement.

Calcium, magnesium, and potassium depletion requiring prolonged replacement were reported in a child with tetany who had just completed a three-week course of i.v. tobramycin.5 The authors suggest this may have been due to kidney damage related to the drug. Seventeen patients with cancer developed calcium, magnesium, and potassium depletion after treatment with aminoglycoside antibiotics, including tobramycin.6 The authors suggested a possible potentiating action of tobramycin-induced mineral depletion by chemotherapy drugs, especially doxorubicin (Adriamycin®).

Until more is known, people receiving i.v. tobramycin should ask their doctor about monitoring calcium, magnesium, and potassium levels and the possibility of mineral replacement.

Reduce Side Effects

A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms-such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii-helps prevent antibiotic-induced diarrhea.7

The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast-such as Saccharomyces boulardii8 or Saccharomyces cerevisiae (baker's or brewer's yeast)9-helps prevent recurrence of this infection.

Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as "dysbiosis"). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.10

A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms-such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii-helps prevent antibiotic-induced diarrhea.11

The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast-such as Saccharomyces boulardii12 or Saccharomyces cerevisiae (baker's or brewer's yeast)13-helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.14 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as "dysbiosis"). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.15

Reduces Effectiveness

Potential Negative Interaction

Explanation Required

Several cases of excessive bleeding have been reported in people who take antibiotics.17, 18, 19, 20 This side effect may result the killing of vitamin K-producing bacteria in the intenstines by the antibiotic. Risk factors for developing antibiotic-induced bleeding include being malnourished or having little or no oral intake (as in people undegoing major surgery or being treated in an intensive care unit).21 Infants may also be at increased risk, since vitamin K status in the first few months of life is often low. Little is known about which antibiotics do and do not promote vitamin K deficiency. People taking an antibiotic should discuss with their doctor the advisability of taking vitamin K.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Aisle7 knowledgebase does not contain every possible interaction.

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2016.

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